| NPI | 1720696099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OK 44505) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT221411) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2026-05-22 |