| NPI | 1548424773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY 42870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R1439) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2022-03-03 |