| NPI | 1902200835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 86371) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD61234746) |
| 207R00000X Internal Medicine (Licence: SC 84734) | |
| 207R00000X Internal Medicine (Licence: WA MD61234746) | |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2025-09-11 |