| NPI | 1972019289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY TP444) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WI 70556) |
| 207RN0300X Internal Medicine, Nephrology (Licence: NJ 25MA11501400) | |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2023-03-31 |