| NPI | 1568495539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: FL ME99831) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J9136) |
| 207RN0300X Internal Medicine Nephrology (Licence: TX J9136) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2008-04-29 |