| NPI | 1619058260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics Pediatric Rheumatology (Licence: AZ 37734) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A91852) |
| 207R00000X Internal Medicine (Licence: CA A91852) | |
| 2080P0216X Pediatrics Pediatric Rheumatology (Licence: CA A91852) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2019-02-12 |