| NPI | 1790744373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 047680) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101045495) |
| 207RN0300X Internal Medicine, Nephrology (Licence: GA 047680) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2022-01-04 |