| NPI | 1306876743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL 90860) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME90860) |
| 207RN0300X Internal Medicine, Nephrology (Licence: KY 37108) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-08-12 |