| NPI | 1962427823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200200166) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: NC 200200166) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2013-05-22 |