| NPI | 1326086448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MI 4301027234) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MI 430127234) |
| 208000000X Pediatrics (Licence: MI 4301027234) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2011-11-16 |