| NPI | 1164592556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A20389) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CA A20389) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2019-08-05 |