| NPI | 1881952091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD60870960) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR 177351) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2018-10-09 |