| NPI | 1467716027 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: MN 62832) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2012020031) | 
| 208000000X Pediatrics (Licence: MN 62832) | |
| 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: WI 73899) | |
| Enumeration Date | 2012-06-28 | 
| Last Update Date | 2020-10-28 |