| NPI | 1265751317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: MO 2017015570) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2017015570) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2025-04-17 |