| NPI | 1205892882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2019-0209) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 15222) |
| 207RN0300X Internal Medicine, Nephrology (Licence: SC 15222) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: NC 31522) | |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2019-10-15 |