| NPI | 1891323564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MN 69582) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MN 69582) |
| 208000000X Pediatrics (Licence: MN 30904) | |
| 208000000X Pediatrics (Licence: MN 69582) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-06-19 |