NPI | 1124412416 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: IL 125.067054) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-03-24 |
Last Update Date | 2021-11-08 |