| NPI | 1124121553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: MO 2010015651) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101233549) |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: VA 0101233549) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2011-06-14 |