| NPI | 1215467923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T2226) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125070683) |
| 207RN0300X Internal Medicine, Nephrology (Licence: IL 036151308) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-11-01 |