| NPI | 1902090178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME123361) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.200916) |
| 207RN0300X Internal Medicine, Nephrology (Licence: LA 200916) | |
| 207R00000X Internal Medicine (Licence: FL ME123361) | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2015-08-25 |