| NPI | 1962485185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 016924) |
| Additional Taxonomies | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: CT 016924) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2011-03-15 |