| NPI | 1215318787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: CA C207604) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 76590-20) |
| 208000000X Pediatrics (Licence: CA C207604) | |
| 208000000X Pediatrics (Licence: MI 4301114154) | |
| 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: WI 76597-20) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2026-07-01 |