| NPI | 1235123621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY 02214) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: OH 34.004747) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2017-04-06 |