| NPI | 1053331561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: AL 28205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD070025L) |
| 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: PA MD070025L) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-01-25 |