| NPI | 1104000629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX N4091) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N4091) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2024-03-04 |