| NPI | 1235450602 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME154401)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 243685)  | 
| 207RN0300X Internal Medicine, Nephrology (Licence: WI 71258)  | |
| 207RN0300X Internal Medicine, Nephrology (Licence: MN 106966)  | |
| 207RN0300X Internal Medicine, Nephrology (Licence: MN 56831)  | |
| Enumeration Date | 2010-06-19 | 
| Last Update Date | 2022-04-14 |