| NPI | 1710171129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD60560532) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 104790) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2016-02-24 |