| NPI | 1194111765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD463824) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NJ 25MA11359900) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2024-04-09 |