| NPI | 1457504664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: NC 2013-00149) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT189894) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2023-07-21 |