| NPI | 1528473733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PR 19128) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 19128) |
| 207RN0300X Internal Medicine, Nephrology (Licence: WI 73735-20) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-08-16 |