| NPI | 1629418603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 110112) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME136875) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2026-04-08 |