| NPI | 1710484241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: WI 75118-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.072445) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2021-06-18 |