| NPI | 1598811788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101244501) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 63172) |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2025-09-23 |