| NPI | 1417055179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: AL 19152) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 202838) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 202838) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-07-21 |