| NPI | 1629502281 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A157437)  | 
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: CA Fellow)  | 
| Enumeration Date | 2017-04-20 | 
| Last Update Date | 2024-07-05 |