| NPI | 1578841789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: AL 33513) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198526) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2020-03-11 |