| NPI | 1023155397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD60084844) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO DR-42456) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2015-03-25 |