| NPI | 1972922169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: CA A137923) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: MI 4301502135) |
| 208000000X Pediatrics (Licence: CA A137923) | |
| 208000000X Pediatrics (Licence: MI 4301502135) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2026-03-04 |