| NPI | 1659695518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX W2457) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101020740) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 5101020740) | |
| 208000000X Pediatrics (Licence: MN 66412) | |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2026-04-08 |