| NPI | 1124060348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 054704) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 054704) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2025-09-11 |