| NPI | 1740220540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2399-23) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: IL 085-002631) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-03-20 |