| NPI | 1881757409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 22497) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: MS 22497) |
| 207RN0300X Internal Medicine, Nephrology (Licence: PA MT188482) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-18 |