| NPI | 1912984790 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 034079)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: SC 30727)  | 
| Enumeration Date | 2005-12-22 | 
| Last Update Date | 2009-12-30 |