| NPI | 1811959687 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX L8128) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX L8128) | 
| 208000000X Pediatrics (Licence: TX L8128) | |
| Enumeration Date | 2006-04-05 | 
| Last Update Date | 2023-04-20 |