| NPI | 1982706818 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OR MD26705)  | 
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD00043844)  | 
| 174400000X Specialist (Licence: WA MD00043844)  | |
| Enumeration Date | 2006-09-01 | 
| Last Update Date | 2022-06-20 |