| NPI | 1790784510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NJ MA03243600) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA03243600) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2024-05-08 |