| NPI | 1417576885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: MO 2023025219) |
| Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: KS 94-11292) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2023-07-03 |