| NPI | 1558307322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: CO DR.0054414) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 04-25510) |
| 208000000X Pediatrics (Licence: MO 102211) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KS 04-25510) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MO 102211) | |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: KS 04-25510) | |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: MO 102211) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CO DR.0054414) | |
| 208000000X Pediatrics (Licence: CO DR.0054414) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2014-12-01 |