| NPI | 1104095017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WI 51858) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NY 10708-0000) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2021-12-13 |