| NPI | 1407385180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI LP03970) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: PA MD478088) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2022-08-10 |