| NPI | 1376705509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 26275) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MO 2026006955) |
| 208000000X Pediatrics (Licence: NE 5864) | |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2026-06-22 |