| NPI | 1578957338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: NE 29726) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 29726) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2025-06-09 |