| NPI | 1932185055 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MN 23810) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WI 60902) | 
| Enumeration Date | 2005-12-20 | 
| Last Update Date | 2021-02-16 |