| NPI | 1871521443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: NC 2010-01376) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 45211) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-01-19 |