| NPI | 1558776062 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: VA 0101284351) | 
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OR MD211150) | 
| 208000000X Pediatrics (Licence: OR MD211150) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: DC MD049177) | |
| 208000000X Pediatrics (Licence: NC 2018-00955) | |
| 208000000X Pediatrics (Licence: NE 30041) | |
| Enumeration Date | 2014-06-23 | 
| Last Update Date | 2025-08-21 |