| NPI | 1114223625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: DC MD043616) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-053408) |
| 208000000X Pediatrics (Licence: IL 125-053408) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OH 35.124012) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OR MD157916) | |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2025-11-24 |