| NPI | 1710116975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: TX 45148) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 003568) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2015-08-12 |