| NPI | 1366539793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A44441) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WY TL3179) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2021-08-02 |