| NPI | 1023637501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U9515) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.43178) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: AL MD.43178) | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2024-07-30 |