| NPI | 1003813130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD053458L) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WV 21795) |
| 207RN0300X Internal Medicine, Nephrology (Licence: OH 35085454) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2018-11-14 |