| NPI | 1922104728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G54765) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA G54765) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2025-09-11 |