| NPI | 1861838617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: DE C1-0013281) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-128794) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35-128794) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2019-09-09 |