NPI | 1366715799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: FL ME123243) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-02-15 |
Last Update Date | 2020-10-27 |