| NPI | 1689135618 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: IN 02007817A)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: IL 036.161002)  | 
| Enumeration Date | 2019-03-31 | 
| Last Update Date | 2025-06-19 |