| NPI | 1184761389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 231873) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME101992) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2011-01-10 |