| NPI | 1780607093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME 97171) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NJ MA34540) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2011-07-27 |