| NPI | 1508247990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080H0002X Pediatrics Hospice and Palliative Medicine (Licence: IA MD-45255) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-45255) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2023-12-18 |