| NPI | 1912153222 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: AZ 50371)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 202074)  | 
| Enumeration Date | 2008-08-18 | 
| Last Update Date | 2025-11-03 |