| NPI | 1588661219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101024987) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: VA 0101024987) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2009-12-08 |