| NPI | 1639384548 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MA 237483) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CT 046979) | 
| Enumeration Date | 2007-05-14 | 
| Last Update Date | 2019-05-01 |