NPI | 1386674182 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: OK 20370) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OK 20370) |
2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OK 20370) | |
Enumeration Date | 2006-07-04 |
Last Update Date | 2013-07-29 |