| NPI | 1205360625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MO 2023014880) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: KS 0449746) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2025-11-26 |