| NPI | 1881686616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 54505) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0061109) |
| 207R00000X Internal Medicine (Licence: RI MD15165) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: MD D0061109) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2024-12-09 |