| NPI | 1124174347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 14105) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CT 14105) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2025-09-11 |