| NPI | 1699750638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2001-01309) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2001-01309) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2026-04-04 |