NPI | 1700909934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: GA 001850) |
Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: TX L8254) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2007-07-08 |