| NPI | 1134741895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME176284) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351046272) |
| 207RN0300X Internal Medicine, Nephrology (Licence: CA A187916) | |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2026-08-11 |