| NPI | 1821086208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD000015726) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD000015726) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2013-03-04 |