| NPI | 1972922466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: KY 55563) |
| Additional Taxonomies | 207RI0008X Internal Medicine Hepatology (Licence: OH 57.024042) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2021-08-16 |