| NPI | 1710955018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: OR MD25092) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: WA MD00044900) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2022-02-04 |