| NPI | 1215258017 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OK 27952) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 27952) | 
| Enumeration Date | 2010-06-15 | 
| Last Update Date | 2024-12-05 |