| NPI | 1568425205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 047146) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: FL ME66355) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 047146) | |
| 208000000X Pediatrics (Licence: FL ME66355) | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2026-06-10 |