NPI | 1356320006 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: WI 49797) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX N6525) |
208000000X Pediatrics (Licence: WI 49797) | |
208000000X Pediatrics (Licence: CO DR 46966) | |
2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: TX N6525) | |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 49797) | |
Enumeration Date | 2006-01-11 |
Last Update Date | 2023-01-09 |