| NPI | 1407086325 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MI 4301110789) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD450223) | 
| Enumeration Date | 2009-07-27 | 
| Last Update Date | 2016-11-30 |