| NPI | 1386908721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZN0300X Specialist/Technologist, Other, Nephrology (Licence: PA MT233257) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125060740) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2025-07-07 |