| NPI | 1710103080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY TP640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 6470) |
| 207R00000X Internal Medicine (Licence: KS 04-32980) | |
| 208M00000X Hospitalist (Licence: KS 04-32980) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-12-09 |