| NPI | 1245809110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY 06426) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT021202) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2026-07-15 |