| NPI | 1861446015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 42501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO CDR.0002692) |
| 207RN0300X Internal Medicine, Nephrology (Licence: MN 42501) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2025-09-15 |