| NPI | 1154361947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35-074003) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: KY 31544) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2011-11-02 |