| NPI | 1609222389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MN 74436) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 74436) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2026-01-21 |