| NPI | 1467872044 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: SC 87391)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 208000000X Pediatrics (Licence: TN 55984)  | |
| Enumeration Date | 2014-04-22 | 
| Last Update Date | 2022-09-08 |