| NPI | 1942472352 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CT 061176) | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: TX M4638) | 
| Enumeration Date | 2008-03-25 | 
| Last Update Date | 2018-07-24 |