| NPI | 1912003161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA C141853) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M2507) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2016-04-22 |