| NPI | 1689800260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 65452) |
| Additional Taxonomies | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: WA OP.60632322) |
| 208000000X Pediatrics (Licence: PA OS015978) | |
| 208000000X Pediatrics (Licence: WI 74419) | |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2021-07-15 |