| NPI | 1215962907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: NY 155353) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 155353) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 155353) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2016-08-24 |