| NPI | 1649654559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 303405) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2024-04-08 |