| NPI | 1154852887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35.146334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301504000) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-03-15 |