| NPI | 1366424129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: FL ME85229) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: LA 15443R) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2014-01-06 |