| NPI | 1043367840 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 66461) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 43211) |
| 207RN0300X Internal Medicine, Nephrology (Licence: GA 66461) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-02-05 |