| NPI | 1407098882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: OH 35.085159) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094633) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2026-01-09 |