| NPI | 1508013749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD60224817) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 250600) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2011-09-12 |