| NPI | 1144316746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: VT 042-0013780) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD 60140495) |
| 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: VA 0101239486) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-07-21 |