| NPI | 1295962462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: FL OS12568) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: FL OS12568) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA OS014712) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL OS12568) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2026-03-02 |