| NPI | 1487754024 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2007-00573)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-4947)  | 
| Enumeration Date | 2006-09-24 | 
| Last Update Date | 2012-05-03 |