| NPI | 1871768986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: FL ME124331) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 65788) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2015-07-01 |