| NPI | 1124266184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD60321439) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: TX P0396) |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: TX P0396) | |
| 2080P0210X Pediatrics, Pediatric Nephrology (Licence: WA MD60321439) | |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2021-05-25 |