| NPI | 1659830925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PR 22264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 22264) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 022264) | |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2024-07-01 |