| NPI | 1417926510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IN 01070542) |
| Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: IN 01070542) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2012-08-10 |