NPI | 1942613062 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: HI DOS1706) |
Additional Taxonomies | 208000000X Pediatrics (Licence: HI DOS1706) |
Enumeration Date | 2014-06-05 |
Last Update Date | 2022-08-08 |