| NPI | 1417113846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX P0650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 270051) |
| 207R00000X Internal Medicine (Licence: TX P0650) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2015-01-08 |