| NPI | 1376533117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MA 78857) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CT 035668) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2014-03-05 |