| NPI | 1174918957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: IL 036146665) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID 125 067013) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-07-12 |