| NPI | 1386641496 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TN 38555) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: GA 055228) | 
| Enumeration Date | 2005-07-05 | 
| Last Update Date | 2010-05-28 |