| NPI | 1710502042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: LA 350363) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: MO 2025035721) |
| 207RN0300X Internal Medicine, Nephrology (Licence: KS 04-51475) | |
| 207R00000X Internal Medicine (Licence: KS 04-51475) | |
| 207R00000X Internal Medicine (Licence: MO 2025035721) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: LA 336951) | |
| 207R00000X Internal Medicine (Licence: LA 336951) | |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2026-05-12 |