| NPI | 1104093624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: MN 75661) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: CT 046990) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 046990) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2024-04-08 |