| NPI | 1386930121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MI 4301111789) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35124111) |
| 207R00000X Internal Medicine (Licence: MI 4301111789) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2018-04-10 |