| NPI | 1114929403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD019281E) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35068280) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2020-01-15 |