| NPI | 1053931980 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NE 3020)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NE 9543)  | 
| 207RN0300X Internal Medicine, Nephrology (Licence: IA DO-06978)  | |
| Enumeration Date | 2020-04-21 | 
| Last Update Date | 2025-06-29 |