| NPI | 1740288307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: OH 35.079000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35079000) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2023-06-09 |