| NPI | 1104146117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: TX N3236) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N3236) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2021-04-15 |