| NPI | 1649240425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: MA 72816) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 72816) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2014-02-11 |