| NPI | 1073267837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 111666) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 111666) |
| 207R00000X Internal Medicine (Licence: GA 111666) | |
| 207RH0000X Internal Medicine, Hematology (Licence: GA 111666) | |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2026-06-10 |