| NPI | 1275556672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A78102) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: CA A78102) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-09 |