| NPI | 1861789125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MI 4301111958) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 264525) |
| 207R00000X Internal Medicine (Licence: IL 036137586) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: IL 036137586) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: NY 264525) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2019-03-14 |