| NPI | 1992091052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 275122) |
| Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: NY 275122) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2023-08-15 |