| NPI | 1366548547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R3091) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00038023) |
| 207RN0300X Internal Medicine, Nephrology (Licence: TX R30091) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: OK MD27500) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2022-03-22 |