| NPI | 1407065766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N6398) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX N6398) |
| 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: TX N6398) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2026-03-11 |