| NPI | 1932361292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 253046) |
| Additional Taxonomies | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: RI MD20462) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 62474) | |
| 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: MA 253046) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2025-02-19 |