| NPI | 1265458681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: IA 40495) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: OH 40495) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2013-09-12 |