| NPI | 1093994576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: MI 4301081195) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301081195) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2017-01-13 |