| NPI | 1811251721 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NH 18869) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0057544) | 
| 207R00000X Internal Medicine (Licence: IL 125062103) | |
| Enumeration Date | 2012-06-26 | 
| Last Update Date | 2018-07-16 |