| NPI | 1942796032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V4919) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX V4919) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2025-09-25 |