| NPI | 1578710158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A126345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092334) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2021-11-30 |