| NPI | 1700874021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: SC 85922) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD049781L) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2021-07-21 |