| 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 |