| NPI | 1619324456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 295848) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 295848) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2023-07-22 |