NPI | 1316130321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: CA A104571) |
Additional Taxonomies | 208000000X Pediatrics (Licence: HI 4804) |
207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA A104571) | |
Enumeration Date | 2007-08-22 |
Last Update Date | 2025-06-16 |