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 |