| NPI | 1659900827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: KY 60545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.249641) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2025-06-16 |