| NPI | 1386028025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NM MD2024-0970) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: AL 37198) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2025-11-10 |