| NPI | 1639601834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CO DR.0068867) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2021-00591) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2025-07-10 |