| NPI | 1053358770 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35.129491)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: RI MD08362)  | 
| Enumeration Date | 2006-06-01 | 
| Last Update Date | 2021-06-21 |