| NPI | 1164505608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: FL ME183627) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SD 7726) |
| 208000000X Pediatrics (Licence: HI 11948) | |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: SD 7726) | |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: ND 11841) | |
| 208000000X Pediatrics (Licence: TN 42313) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2026-09-01 |