| NPI | 1467497859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: MA 257792) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 257792) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2018-09-26 |