| NPI | 1982639324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: NY 240901) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 240901) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2015-07-20 |