| NPI | 1750765749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 294532)  | 
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NY 294532)  | 
| Enumeration Date | 2015-07-20 | 
| Last Update Date | 2024-02-21 |