| NPI | 1437483427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX J1103) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX J1103) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TX J1103) | |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |