| NPI | 1831148576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: VA 0101049215) |
| Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: VA 0101049215) |
| 208000000X Pediatrics (Licence: VA 0101049215) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2009-12-07 |