| NPI | 1508857129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: KY 42958) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: PA MD035327E) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2010-03-22 |