| NPI | 1124011143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY 35128) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 35128) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2007-12-28 |