| NPI | 1962817783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX S5041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-39389) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2021-07-07 |