| NPI | 1669862462 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: NJ 25MA11379800)  | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: WI 68801)  | 
| 208000000X Pediatrics (Licence: WI 68801)  | |
| Enumeration Date | 2015-01-31 | 
| Last Update Date | 2022-08-18 |