| NPI | 1265482772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MT MED-PHYS-LIC-88487) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A66856) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-05-18 |