| NPI | 1104909571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: MA 78949) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 78949) |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2022-08-30 |