| NPI | 1205061900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics Pediatric Nephrology (Licence: IA MD-42590) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11014822A) |
| Enumeration Date | 2009-05-25 |
| Last Update Date | 2015-06-04 |