| NPI | 1487646477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WI 30363) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WI 30636) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2010-01-14 |