| NPI | 1881630143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY 34803) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35-078078) |
| 207RN0300X Internal Medicine, Nephrology (Licence: IN 01049480A) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2011-11-02 |