| 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 |