NPI | 1952354110 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MD D76446) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: PA MD041142E) |
Enumeration Date | 2006-05-18 |
Last Update Date | 2013-09-16 |