| NPI | 1467493288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: FL ME86363) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME86363) |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: FL ME86363) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2019-12-13 |