| NPI | 1366977100 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A163343) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ZZ 357062) | 
| 207RN0300X Internal Medicine, Nephrology (Licence: CA PTAL) | |
| Enumeration Date | 2017-05-01 | 
| Last Update Date | 2023-08-04 |