| NPI | 1295710218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 91975) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: FL ME91975) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2023-06-13 |