| NPI | 1598743361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: IN 01062019A) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35078839) |
| 208D00000X General Practice (Licence: KY 36526) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2016-04-28 |