| NPI | 1821358540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-13012) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 29158) |
| 207RN0300X Internal Medicine, Nephrology (Licence: TX R1246) | |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2021-02-11 |