| NPI | 1376602060 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MS 23573) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: IN 02003331A) | 
| Enumeration Date | 2006-12-08 | 
| Last Update Date | 2025-04-30 |