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Individual
NAIM S ISSA
Active
Individual
NAIM S ISSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
50006
MN
207RN0300X
Nephrology Physician
Primary
50006
MN
207RN0300X
Nephrology Physician
51113
WI
Other
Enumeration date
06/20/2007
Last updated
08/14/2020
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