| NPI | 1285211532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC LL92838) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RN0300X Internal Medicine, Nephrology (Licence: SC NA) | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-07-02 |