| NPI | 1760652119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX M7595) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX M7595) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2015-03-25 |