| NPI | 1346620770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME126913) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME126913) |
| 207R00000X Internal Medicine (Licence: NY 280758) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2019-10-03 |