| NPI | 1851649669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2018-00585) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: AL 34461) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2021-08-10 |