| NPI | 1225060908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: FL ME135748) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: OH 35.054631) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2018-07-31 |