| NPI | 1780034306 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: AZ 007892)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 007892)  | 
| 207R00000X Internal Medicine (Licence: FL OS14782)  | |
| 207RN0300X Internal Medicine, Nephrology (Licence: TX T4231)  | |
| Enumeration Date | 2016-06-14 | 
| Last Update Date | 2024-12-02 |