| NPI | 1912920679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY 36247) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 36247) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2012-02-07 |