| NPI | 1720054323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: AZ 53293) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD066496L) |
| 208000000X Pediatrics (Licence: AZ 53293) | |
| 208000000X Pediatrics (Licence: PA MD066496L) | |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: PA MD066496L) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2019-06-11 |