| NPI | 1801888250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MS 08138) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 08138) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2025-09-11 |