| NPI | 1164981965 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MI 5101027937) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04718) | 
| 207RN0300X Internal Medicine, Nephrology (Licence: WA OL61280717) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-19 | 
| Last Update Date | 2024-10-30 |