| NPI | 1366414674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 70389) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL 70389) |
| 207RN0300X Internal Medicine, Nephrology (Licence: FL 70389) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2015-03-09 |