| NPI | 1245509108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX Q0394) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 267748) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2017-07-11 |