| NPI | 1255440459 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA OP60007005) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR DO26307) | 
| 207RN0300X Internal Medicine, Nephrology (Licence: ID O-0476) | |
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2023-03-07 |