| NPI | 1316914526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 47846) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2010-01177) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2021-06-08 |