| NPI | 1124119219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 049266) |
| Additional Taxonomies | 2472R0900X Technician, Other, Renal Dialysis (Licence: GA 049266) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-07-07 |