| NPI | 1083585889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: IA A186983) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA A186983) |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2025-10-24 |