| NPI | 1699094292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A125533) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A125533) |
| 207R00000X Internal Medicine (Licence: PA MT197042) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197042) | |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2022-07-21 |