| 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 |