NPI | 1114028511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME39025) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: FL ME0039025) |
Enumeration Date | 2006-09-26 |
Last Update Date | 2014-11-26 |