| NPI | 1023039831 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: CA G64029)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G64029)  | 
| Enumeration Date | 2006-07-21 | 
| Last Update Date | 2011-10-14 |