| NPI | 1033640982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61156816) |
| Additional Taxonomies | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: WA MD61156816) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2024-09-19 |