| NPI | 1366650236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: FL ME114452) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MO 2006035310) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2021-12-13 |