| NPI | 1477854891 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME108779) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME108779) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-11-17 | 
| Last Update Date | 2024-05-21 |