| NPI | 1528550597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TN 5278) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: KY 05584) |
| 207R00000X Internal Medicine (Licence: VA 0116031646) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2025-10-30 |