| NPI | 1265413298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: WI 51603) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: IA 27617) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2011-09-15 |