| NPI | 1912263310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CO DR.0064128) |
| Additional Taxonomies | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: CO DR.0064128) |
| 207R00000X Internal Medicine (Licence: NC 2017-02203) | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2024-05-28 |