| NPI | 1518925346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA000284L) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: PA MA000284L) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2020-10-25 |