| NPI | 1679564678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MS 19802) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35087077) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2008-08-12 |