| NPI | 1861656100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD435296) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NJ 25MA08578100) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2022-06-02 |