| NPI | 1811403124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 96214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME149480) |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2024-07-02 |