| NPI | 1417215252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MN 63764) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD SD) |
| 207R00000X Internal Medicine (Licence: IA 43876) | |
| 207R00000X Internal Medicine (Licence: MN 63764) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: SD 8483) | |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2025-08-13 |