| NPI | 1912170713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME122602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35091072) |
| Enumeration Date | 2008-04-12 |
| Last Update Date | 2017-03-16 |