| NPI | 1487671293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD00038481) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00038481) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2015-10-19 |