| NPI | 1689101313 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: NJ 25MA12709300) | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NJ 25MA12709300) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-12 | 
| Last Update Date | 2025-07-03 |