| NPI | 1558680587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: ID O-1209) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: OH 012787) |
| 208D00000X General Practice (Licence: VA 0102202953) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2023-03-07 |