| NPI | 1063779759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 201700586) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2017-00586) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2025-03-15 |