| NPI | 1689652844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101224960) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: MD D0064152) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2022-04-20 |