| NPI | 1104266618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: ND 15479) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10047724) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2022-04-04 |