| NPI | 1104379239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OK 32446) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 32446) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2026-01-20 |