| NPI | 1750313151 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA 60166663)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CA A86094)  | 
| 207RN0300X Internal Medicine, Nephrology (Licence: LA MD.203487)  | |
| Enumeration Date | 2006-07-07 | 
| Last Update Date | 2017-02-10 |