| NPI | 1114902657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA G059677) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME 107406) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2010-07-14 |