| NPI | 1689686610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: TX K3796) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX K3796) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2024-09-19 |