| NPI | 1760489892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.021048) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA MD.021048) |
| 207RN0300X Internal Medicine, Nephrology (Licence: LA MD.021048) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2021-02-16 |