| NPI | 1528629052 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME154270) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: MN 33818) | 
| Enumeration Date | 2019-06-25 | 
| Last Update Date | 2023-06-13 |