| NPI | 1932660081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: CA A204615) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 325934) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2026-02-27 |