| NPI | 1942576863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2016-01828) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2016-01828) |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2021-03-31 |