| NPI | 1689203903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 77351) |
| Additional Taxonomies | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: WI 77351) |
| 208M00000X Hospitalist (Licence: WI 77351) | |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2023-08-01 |