| NPI | 1972501872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD0006983E) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME-11834) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2007-08-02 |