| NPI | 1538396163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM A-1829-14) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NM RS12345) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2014-09-04 |