| NPI | 1326417916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A168749) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10309200) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2022-04-05 |