| NPI | 1912971250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 169142) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 169142) |
| 174400000X Specialist (Licence: WI 38379) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: WI 38379-020) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2019-10-28 |