| NPI | 1568858017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX T1535) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01082926A) |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2025-11-26 |