| NPI | 1992788160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MA 81014) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CT 032013) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2015-02-06 |