| NPI | 1811483811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME174110) |
| Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: FL ME174110) |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2025-12-09 |