| NPI | 1083808695 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: VA 0101252262) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 30536) | 
| 207RN0300X Internal Medicine, Nephrology (Licence: MD MT187918) | |
| Enumeration Date | 2007-08-28 | 
| Last Update Date | 2012-08-15 |