| NPI | 1629453915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 72433) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125066798) |
| 207RN0300X Internal Medicine, Nephrology (Licence: NE 8136) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2020-06-25 |