| NPI | 1972604981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: MN 30336) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 30336) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-04-18 |