| NPI | 1740501154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WV 28838) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P5051) |
| 207R00000X Internal Medicine (Licence: MN 63207) | |
| 207R00000X Internal Medicine (Licence: PA MT197028) | |
| 207R00000X Internal Medicine (Licence: PA MT196566) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: MN 63207) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2023-02-08 |