| NPI | 1558551283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics Pediatric Nephrology (Licence: MA 281426) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 281426) |
| 208000000X Pediatrics (Licence: PA MD431964) | |
| 208000000X Pediatrics (Licence: MI 4301097950) | |
| 2080P0210X Pediatrics Pediatric Nephrology (Licence: MI 4301097950) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2019-10-14 |