| NPI | 1154771772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WI 1008-320) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.147812) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2022-01-13 |