| NPI | 1407059090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: MI 4301509579) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N7190) |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: TX N7190) | |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2023-09-13 |