| NPI | 1265556989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: SC 82049) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301085639) |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: MI 4301085639) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301085639) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2019-05-29 |