| NPI | 1073074167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 98199) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 98199) |
| 208M00000X Hospitalist (Licence: GA 98199) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208D00000X General Practice (Licence: GA 98199) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2026-07-07 |