| NPI | 1912090572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX N1236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 39997) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-12-22 |