| NPI | 1912352931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: MO 2025040384) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2025040384) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: MO 2025040384) | |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2025-10-06 |