| NPI | 1760466528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 021731) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: CT 021731) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2015-10-22 |