| NPI | 1093783177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35094031) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: KY 42585) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2012-08-03 |