NPI | 1902875842 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA C37651) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA C37651) |
Enumeration Date | 2006-03-14 |
Last Update Date | 2007-07-08 |