| NPI | 1013070424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 59081) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: LA 015961) |
| 207RN0300X Internal Medicine Nephrology (Licence: GA 059081) | |
| 246ZN0300X Specialist/Technologist, Other Nephrology | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2019-12-03 |