| NPI | 1558563817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: AZ 50254) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: KY 44955) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2019-09-30 |