| NPI | 1508109836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 282646) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 282646) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2023-07-07 |