| NPI | 1700813318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A74153) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L3517) |
| 207RN0300X Internal Medicine, Nephrology (Licence: TX L3517) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2014-05-20 |