| NPI | 1790753408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A54268) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A54268) |
| 207R00000X Internal Medicine (Licence: AZ 25375) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: AZ 25375) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2009-05-18 |