| NPI | 1457614182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35131540) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: KY 50456) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2022-07-21 |