| NPI | 1689102717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: AR E-19262) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S5280) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2026-06-26 |