| NPI | 1578697454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME105291) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: AL 30678) |
| 207P00000X Emergency Medicine (Licence: OH 35088500) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2025-07-01 |