| NPI | 1780972133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT199011) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: TX Q8641) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2018-10-18 |