| NPI | 1518967611 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX H5952) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: AR N7612) | 
| Enumeration Date | 2005-07-29 | 
| Last Update Date | 2007-07-14 |