| NPI | 1376569913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: MD D60593) |
| Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: DC MD034382) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2012-07-30 |