| NPI | 1790947927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: TX R2489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT192793) |
| 207R00000X Internal Medicine (Licence: PA MD443143) | |
| 207R00000X Internal Medicine (Licence: OH 35.099712) | |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2020-11-06 |