NPI | 1548427420 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NJ 25MA09525800) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: PA MT198441) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2008-05-19 |
Last Update Date | 2014-07-16 |