| NPI | 1669439469 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: OH 35-046637) | 
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: LA MD15331R) | 
| Enumeration Date | 2006-04-27 | 
| Last Update Date | 2013-07-17 |