| NPI | 1811420821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: CA A182955) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A182955) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2024-04-27 |