| NPI | 1154419521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD025756) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: OH 35.090623) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2018-07-05 |