| NPI | 1649621053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OR MD224247) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.027492) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2025-07-09 |