| NPI | 1275520793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 036745) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 036745) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2012-03-22 |