| 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 |