| NPI | 1164627840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MN 50006) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 50006) |
| 207RN0300X Internal Medicine, Nephrology (Licence: WI 51113) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2020-08-14 |