| NPI | 1154522969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WI 62289-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: WI 6228920) | |
| 207R00000X Internal Medicine (Licence: WV 23321) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2026-01-29 |