NPI | 1407055130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: MT 20823) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MT 20823) |
Enumeration Date | 2007-07-12 |
Last Update Date | 2021-06-02 |