| NPI | 1174652044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 246705) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 246705) |
| 207R00000X Internal Medicine (Licence: MI 4301083653) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2010-09-08 |