| NPI | 1821269804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A102847) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A102847) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A102847) | |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2015-04-03 |