| NPI | 1134519275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PR 21336) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 13629i) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2021-03-09 |