NPI | 1174906861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: FL ME137201) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 31606R) |
Enumeration Date | 2015-06-30 |
Last Update Date | 2020-10-20 |