| NPI | 1962466888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: SC 6890) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: GA 009271) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2012-12-10 |