| NPI | 1811159031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: RI MD13258) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI MD13258) |
| 208000000X Pediatrics (Licence: ND 20114) | |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2025-11-03 |