| NPI | 1154465888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CO 49322) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 221758) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2013-09-19 |