| NPI | 1770212433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0210X Pediatrics Pediatric Nephrology (Licence: WI 82344) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A68546) |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2023-08-28 |