| NPI | 1407169477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL os12544) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 2484) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2014-09-17 |