| NPI | 1003207978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 63855) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 31007R) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2017-03-29 |