| NPI | 1780635920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A116149) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35090745) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2025-06-13 |