| NPI | 1326243866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: RI MD12388) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI MD12388) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2010-05-14 |