| NPI | 1619900982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MD D0070470) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD431551) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT193580) | |
| 207R00000X Internal Medicine (Licence: WA MD00040872) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2026-05-12 |