| NPI | 1851382402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME103154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 224081) |
| 207R00000X Internal Medicine (Licence: FL ME103154) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: MA 224081) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2010-01-19 |