| NPI | 1568811602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 95274) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL39373) |
| 208000000X Pediatrics (Licence: SC LL39373) | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2025-04-08 |