| NPI | 1245215441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: PA MD484203) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD484203) |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: NY 002036-1) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2024-05-22 |