| NPI | 1174610273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA C149852) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME92869) |
| 207RN0300X Internal Medicine, Nephrology (Licence: FL ME92869) | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-02-26 |