| NPI | 1669404588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: WI 103478-875) |
| Additional Taxonomies | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: IL 036.101801) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2026-03-11 |