| NPI | 1154318764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A73550) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CA A73550) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2007-07-08 |