| NPI | 1124366240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: UT 11713622-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL Me115846) |
| 208M00000X Hospitalist (Licence: FL ME115846) | |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2021-11-17 |