| NPI | 1558302851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY 21310) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35-043162) |
| 207RN0300X Internal Medicine, Nephrology (Licence: IN 01034108) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2012-08-06 |