| NPI | 1124089016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WV 16005) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: VA 0101043986) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2015-07-10 |