| NPI | 1497714810 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101242025) | 
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX L9325) | 
| 208000000X Pediatrics (Licence: OR MD218906) | |
| Enumeration Date | 2006-03-23 | 
| Last Update Date | 2024-08-15 |