| NPI | 1174574834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2020-0101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q9258) |
| 207R00000X Internal Medicine (Licence: PA MD463332) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: WI 47430) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: OK 30882) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2025-01-21 |