| NPI | 1104897537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 38380) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 38380) |
| 207R00000X Internal Medicine (Licence: NC 38380) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2022-07-21 |