| NPI | 1578901625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MO 2019022596) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: KS 04-39135) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2019-07-29 |