| NPI | 1275772931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: OH 35.096950) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 003533) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2022-02-18 |