| NPI | 1366424384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 155242) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 155242) |
| 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: MA 155242) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2020-11-10 |