| NPI | 1619157310 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2013-02240)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: SC 84787)  | 
| 207RN0300X Internal Medicine, Nephrology (Licence: GA 61484)  | |
| Enumeration Date | 2007-11-09 | 
| Last Update Date | 2024-03-19 |