| NPI | 1316399587 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35.148257)  | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.148257)  | 
| 207R00000X Internal Medicine (Licence: OH 35.148257)  | |
| Enumeration Date | 2016-07-12 | 
| Last Update Date | 2025-11-03 |