| NPI | 1245284397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: UT 14220717-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35086331) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2025-12-05 |