| NPI | 1053088815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: VA 0101288481) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10075651) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2026-05-18 |