NPI | 1477711091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA C169640) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KY 47298) |
2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: KY 47298) | |
2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: CA C169640) | |
Enumeration Date | 2008-05-30 |
Last Update Date | 2023-06-08 |