| NPI | 1689761769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: CA G83725) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 178899) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2010-05-28 |