| NPI | 1972066587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WA OP61689646) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 12751743-1204) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2025-08-19 |