| NPI | 1760652879 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME107810) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: DC MD037977) | 
| Enumeration Date | 2008-03-04 | 
| Last Update Date | 2024-12-18 |