| NPI | 1972667202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WV 24463) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 24463) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WV 24463) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2021-03-14 |