| NPI | 1609294016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: MA 294008) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CT 69301) |
| 208000000X Pediatrics (Licence: CT 69301) | |
| 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: CT 69301) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2022-09-14 |