| NPI | 1790918696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G080094) |
| Additional Taxonomies | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: CA g080094) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2023-03-30 |