| NPI | 1821243759 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A124891) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A124891) | 
| Enumeration Date | 2008-11-19 | 
| Last Update Date | 2020-05-22 |