| NPI | 1710266259 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2023-00944)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: VA 0116030828)  | 
| Enumeration Date | 2011-08-15 | 
| Last Update Date | 2025-02-20 |