| NPI | 1467694661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2017-00545) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NC 2017-00545) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2022-12-22 |