| NPI | 1821347097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME0049564) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: GA 32450) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2016-02-23 |