| NPI | 1972796985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX M8241) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NM MD2007-0494) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2022-03-29 |