| NPI | 1053393363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 7875) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 27723) |
| 207RN0300X Internal Medicine, Nephrology (Licence: IA 27723) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2025-11-14 |