| NPI | 1174607436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: MN 19499) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 19499) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2012-10-26 |