| NPI | 1740667534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX T2878) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CA 20A15603) |
| 207R00000X Internal Medicine (Licence: OK 5985) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2026-05-14 |