| NPI | 1639113624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35077206) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: KY 33828) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2011-11-02 |