| NPI | 1124128996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: WV 22506) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 22506) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2018-04-16 |