| NPI | 1538124771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: AL 37612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 45190) |
| 207R00000X Internal Medicine (Licence: VA 0101230582) | |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: TN 45190) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2019-04-10 |