| NPI | 1912226002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA 20A 11150) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A 11150) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2014-07-25 |