| NPI | 1366632408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301101630) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 5153720) |
| 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: WI 5153720) | |
| 207R00000X Internal Medicine (Licence: WI 5153720) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 4301101630) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2026-04-03 |