| NPI | 1861484917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 049593) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 049593) |
| 207RN0300X Internal Medicine Nephrology (Licence: FL ME79683) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2015-01-06 |