| NPI | 1598981128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX C4493) |
| Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: TX C4493) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX C4493) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |