| NPI | 1851656706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MO 2019024489) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: MO 2019024489) |
| 208000000X Pediatrics (Licence: OK 29218) | |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2019-08-26 |