| NPI | 1891353108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A177395) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT217271) |
| Enumeration Date | 2019-06-01 |
| Last Update Date | 2025-08-01 |