| NPI | 1952306995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35046051A) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD033274E) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2014-08-19 |