| NPI | 1477966935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KY 52199) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD xxxxxxxxxxxxxxxx) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2019-05-08 |