| 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 |