| NPI | 1346205564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX K1771) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX K1771) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2025-10-02 |