| NPI | 1265694244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: WV 30292) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 30292) |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: OH 35.092030) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2021-12-01 |