| NPI | 1356428072 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: ME MD25822)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NY 217627)  | 
| Enumeration Date | 2006-11-01 | 
| Last Update Date | 2022-05-24 |