| NPI | 1558397299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics Pediatric Nephrology (Licence: MS 21228) |
| Additional Taxonomies | 2080P0210X Pediatrics Pediatric Nephrology (Licence: FL ME91725) |
| 207RN0300X Internal Medicine Nephrology (Licence: FL ME91725) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2016-05-20 |