| NPI | 1689152068 |
|---|---|
| Former Name | TIMOTHY JAMES CASON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 75686-21) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2024-12-05 |