| NPI | 1033103080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX M1325) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NM MD2013-0819) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2014-10-22 |