| NPI | 1497831341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NY 199923) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 199923) |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: NY 199923) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2024-03-22 |