| NPI | 1144660549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: CT 66385) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101257425) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2020-08-20 |