| NPI | 1962023036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 13480807-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R78096) |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2024-06-19 |