| NPI | 1366897274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: CA A140320) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A140320) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2025-01-23 |