| NPI | 1093770984 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MO R6319) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R6319) | 
| Enumeration Date | 2006-04-20 | 
| Last Update Date | 2012-12-14 |