| NPI | 1104805126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD043284E) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: PA MD043284E) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2007-07-08 |