| NPI | 1508122540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CO DR.0065972) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: PA MT207845) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2026-03-04 |