| NPI | 1881881258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MA 274993) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME109277) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2018-07-20 |