| NPI | 1720601172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301509077) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 4301509077) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2026-06-30 |