| NPI | 1407019037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: IN 01069102A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA Mt 187877) |
| 207R00000X Internal Medicine (Licence: OH 35095420) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2020-04-02 |