| NPI | 1104074384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: AZ 21087) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: LA MD.INT) |
| Enumeration Date | 2008-08-31 |
| Last Update Date | 2011-04-21 |