| NPI | 1174802292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MI 4301099599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301099599) |
| Enumeration Date | 2011-08-07 |
| Last Update Date | 2018-05-23 |