| NPI | 1063742377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: FL ME131099) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: KY 46019) |
| 207RN0300X Internal Medicine Nephrology (Licence: NJ 25MA09130100) | |
| 207RN0300X Internal Medicine Nephrology (Licence: WV 25211) | |
| 207RN0300X Internal Medicine Nephrology (Licence: VA 0101257258) | |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2018-04-02 |