| NPI | 1750310108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics Child Abuse Pediatrics (Licence: PA MD450605) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD450605) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2020-04-07 |