| NPI | 1033172952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NY 119952) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 119952) |
| 174400000X Specialist (Licence: NY 119952) | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2024-02-12 |