| NPI | 1154334464 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX F8471) | 
| Additional Taxonomies | 174400000X Specialist (Licence: TX F8471) | 
| Enumeration Date | 2006-08-15 | 
| Last Update Date | 2020-06-03 |