| NPI | 1942219506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: OH 35.128815) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME69250) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2016-08-08 |