| NPI | 1700143930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: UT 8841776-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 8841776-1205) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2021-11-19 |