| NPI | 1639706732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MD D0105903) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: VT 042.0016923) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-04-06 |