| NPI | 1306307780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: FL ME174065) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2019018167) |
| 208000000X Pediatrics (Licence: KS 9409841) | |
| 208000000X Pediatrics (Licence: FL ME174065) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-07-23 |