| NPI | 1992182885 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: WA OP61077765) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A15144) | 
| 208000000X Pediatrics (Licence: WA op61077765) | |
| 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: CA 20A15144) | |
| Enumeration Date | 2015-04-30 | 
| Last Update Date | 2020-08-24 |