| NPI | 1255586178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA OS016391) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RN0300X Internal Medicine, Nephrology (Licence: NJ 25MB08851100) | |
| 207R00000X Internal Medicine (Licence: NJ 25MB08851100) | |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2017-12-15 |