| NPI | 1619257003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME148284) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NY 282309) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2023-08-18 |