| NPI | 1902179666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD450886) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NY 274121) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2021-03-26 |