| NPI | 1235544842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: AR E-18431) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-18431) |
| 208000000X Pediatrics (Licence: OK 30745) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2024-10-11 |