| NPI | 1194042481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: ME MD21830) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: NY 264365) |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: ID M-17035) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2023-03-01 |