| NPI | 1619350337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A161190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 289590) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2022-06-14 |