| NPI | 1801212824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D75096) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D75096) |
| 207RN0300X Internal Medicine, Nephrology (Licence: MD D75096) | |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2015-05-10 |