| NPI | 1326169319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GU MD-1466) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI MD-13520) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: GU MD-1466) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: HI MD-13520) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2021-05-04 |