| NPI | 1750307187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WV 23796) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 27151) |
| 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: KY 27151) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2014-08-13 |