| NPI | 1306399043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 78916) |
| Additional Taxonomies | 286500000X Military Hospital |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2021-07-27 |