| NPI | 1700197266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2013-01016) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT013489) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2023-08-21 |