NPI | 1881746899 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: OR 182551) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VT 0420010479) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2022-07-21 |