| NPI | 1487863049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 44786) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: KY 44786) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2017-01-13 |