| NPI | 1821309188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MA 256217) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-8776) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2021-10-16 |