NPI | 1255863403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 69030) |
Additional Taxonomies | 2080H0002X Pediatrics Hospice and Palliative Medicine (Licence: MN 69030) |
Enumeration Date | 2017-03-28 |
Last Update Date | 2022-02-18 |