| NPI | 1235116005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 136466) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 136466) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2017-01-06 |