| NPI | 1760837165 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 201900335)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-00335)  | 
| Enumeration Date | 2016-05-04 | 
| Last Update Date | 2021-09-20 |