| NPI | 1063402105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MA 55789) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CT 035565) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2022-01-11 |