| NPI | 1023318896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD038739) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: DC MD038739) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |