| NPI | 1558518084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: NE 25441) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 25441) |
| 208D00000X General Practice (Licence: NE 25441) | |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2024-01-31 |