| NPI | 1033663323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.249865) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: TX BP10055882) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2020-06-10 |