| NPI | 1962818807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME149154) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CA A149943) |
| 207R00000X Internal Medicine (Licence: MA 260304) | |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2025-10-30 |