| NPI | 1891887576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX F1764) |
| Additional Taxonomies | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: TX F1764) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2011-11-10 |