| NPI | 1003475039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA 20A19885) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151013415) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2024-09-10 |