| NPI | 1780793968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60078160) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML20008690) |
| 2080C0008X Pediatrics, Child Abuse Pediatrics | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-08-13 |