| NPI | 1477661825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD61476127) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 47224) |
| 207R00000X Internal Medicine (Licence: WI 68231-20) | |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2026-04-09 |