| NPI | 1205887973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX G0858) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX G0858) |
| 207RN0300X Internal Medicine, Nephrology (Licence: TX G0858) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2022-12-15 |