| NPI | 1811055080 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME103955)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WI 51437-20)  | 
| 207R00000X Internal Medicine (Licence: WI 51437-20)  | |
| Enumeration Date | 2006-12-04 | 
| Last Update Date | 2024-04-19 |