| 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 |