| NPI | 1386422269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NY 333901) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2025-09-25 |