| NPI | 1508398223 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: OH 35.141581)  | 
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.141581)  | 
| Enumeration Date | 2017-03-31 | 
| Last Update Date | 2025-09-04 |