| NPI | 1528044831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MT 74531) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA G71800) |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: MT 74531) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2019-07-16 |