| NPI | 1366692253 |
|---|---|
| Professional Name | N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NJ MA-04723600) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NY 223131) |
| 207RN0300X Internal Medicine, Nephrology (Licence: PA MD-032545-E) | |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2020-05-03 |