NPI | 1407436603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: MI 4351048146) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4351048146) |
Enumeration Date | 2021-04-12 |
Last Update Date | 2025-07-28 |