| NPI | 1255642732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301096898) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 4301096898) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2025-06-04 |