NPI | 1760402002 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: TX U5735) |
Additional Taxonomies | 208000000X Pediatrics (Licence: GA 65581) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2025-10-02 |