| NPI | 1740624741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: CT 62434) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 285316-1) |
| 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: TX BP10055662) | |
| 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: MA 285677) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-20 |
| Last Update Date | 2022-11-30 |