| NPI | 1720002140 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NC 9600637)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9600637)  | 
| 208000000X Pediatrics (Licence: NC 9600637)  | |
| Enumeration Date | 2006-07-27 | 
| Last Update Date | 2023-05-04 |