| NPI | 1275595431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: TX H3170) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: TX H3170) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX H3170) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2024-12-10 |