| NPI | 1457358160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: ME MD23464) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL 77117) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2019-10-29 |