| NPI | 1174904734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: FL ME146261) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: CA A152878) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2024-06-27 |