| NPI | 1619144474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: KY 41863) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: KY TP843) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2015-08-10 |