| NPI | 1730506999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MA 270861) |
| Additional Taxonomies | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: MA 270861) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2023-07-04 |