| NPI | 1922067776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: MN 58673) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M2075) |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: SC 1154) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-08-20 |