| NPI | 1053315549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD042825E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD042825E) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2021-02-10 |