| NPI | 1952500639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: KY 17968) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 17968) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2014-09-09 |