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 |