| NPI | 1912219312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD455111) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT196499) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2018-12-07 |