| NPI | 1740400902 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: PA MD424164) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD424164) | 
| Enumeration Date | 2007-04-27 | 
| Last Update Date | 2009-07-29 |