| NPI | 1497838239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: SC 39702) |
| Additional Taxonomies | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: OH 35.121093) |
| 208000000X Pediatrics (Licence: OH 35.121093) | |
| 207R00000X Internal Medicine (Licence: OH 35.121093) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2017-01-23 |