| NPI | 1043594120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: NJ 25MA07629100) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: UT 176291-1205) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-10-06 |