| NPI | 1235130691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MI 4301077565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301077565) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2023-03-07 |