| NPI | 1558599407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: TX P5932) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 047983) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: CT 047983) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2021-05-04 |