| NPI | 1649602160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NC 202201943) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 29721) |
| 207R00000X Internal Medicine (Licence: WI 66071) | |
| 207R00000X Internal Medicine (Licence: CA a175051) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2023-07-07 |