| NPI | 1265435564 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 037953)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: GA 037953)  | 
| 174400000X Specialist (Licence: SC 15425)  | |
| 207RN0300X Internal Medicine, Nephrology (Licence: SC 15425)  | |
| Enumeration Date | 2005-05-31 | 
| Last Update Date | 2012-08-22 |