| NPI | 1508119736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD60566032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P7514) |
| 207RN0300X Internal Medicine, Nephrology (Licence: TX P7514) | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2022-10-25 |