| NPI | 1861059263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A192998) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A192998) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2024-07-01 |