| NPI | 1679034821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NC 2024-01294) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2024-11-11 |