| NPI | 1184653891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MA 45103) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 45103) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2011-04-25 |