| NPI | 1568459196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MI LG009318) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 5101009318) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2025-02-08 |