| NPI | 1093202574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD61167673) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61167673) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2023-09-28 |