NPI | 1407892821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD065544L) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: PA MD065544L) |
2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: PA MD065544L) | |
Enumeration Date | 2006-06-22 |
Last Update Date | 2007-07-08 |