| NPI | 1003827668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: MO 2001016564) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2001016564) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2021-01-11 |