| NPI | 1770693913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0210X Pediatrics Pediatric Nephrology (Licence: NC 27635) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 04-28382) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2011-02-10 |