| NPI | 1821733080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: UT 14210863-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 390200000X) |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2025-03-19 |