| NPI | 1831109461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 4301047606) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301047606) |
| 208000000X Pediatrics (Licence: MI 4301047606) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2012-11-21 |