| NPI | 1508840612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: RI 8373) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: MA 53848) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2019-10-04 |