| 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 |