| NPI | 1083608426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 229355) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: NY 229355) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2015-09-09 |