| NPI | 1669620308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 64056) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NC 18629) |
| Enumeration Date | 2008-09-07 |
| Last Update Date | 2008-09-07 |