| NPI | 1164725875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2011-01518) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 282N00000X General Acute Care Hospital | |
| 207R00000X Internal Medicine (Licence: NC 2011-01518) | |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2016-04-26 |