| NPI | 1801276639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A176208) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A176208) |
| 207RN0300X Internal Medicine, Nephrology (Licence: CT 67012) | |
| Enumeration Date | 2015-06-06 |
| Last Update Date | 2022-07-05 |