| NPI | 1831322932 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125-057074)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: IN 01075950A)  | 
| 207RN0300X Internal Medicine, Nephrology (Licence: MT MED-PHYS-LIC-50732)  | |
| 207RN0300X Internal Medicine, Nephrology (Licence: KY 50743)  | |
| Enumeration Date | 2009-08-24 | 
| Last Update Date | 2024-06-27 |