| NPI | 1679131965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: PA MD476868) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD476868) |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2025-07-14 |