| NPI | 1073616611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD00043592) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00043592) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2021-04-05 |