| NPI | 1225343486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics Pediatric Nephrology (Licence: WA MD60537129) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ZZ TRN13848) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2021-05-25 |