| NPI | 1013029487 |
|---|---|
| Professional Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA G45263) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G45263) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-01-11 |