| NPI | 1770739641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: WY TL8345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT192189) |
| 207RN0300X Internal Medicine Nephrology (Licence: MD D79829) | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2024-09-11 |