| NPI | 1780213975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: LA 350405) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: AL MD.43199) |
| 208000000X Pediatrics (Licence: AL MD.43199) | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2026-06-19 |