| NPI | 1326453952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WV 28736) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 28736) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2021-11-18 |