| NPI | 1780831529 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MN 74040) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092257) | 
| 207RN0300X Internal Medicine, Nephrology (Licence: KY 47731) | |
| Enumeration Date | 2008-08-22 | 
| Last Update Date | 2024-11-04 |