| NPI | 1417417478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 30295) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WV 30295) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2025-01-30 |