| NPI | 1871925297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: LA 312265) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 20938) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2019-09-20 |