| NPI | 1396171070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 85562) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.022431) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2020-12-17 |