| NPI | 1861489759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2003-00428) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC NC2003-00428) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2014-03-21 |