| NPI | 1982624086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: FL ME79443) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200600108) |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: NC 2006-00108) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-06-16 |