NPI | 1720501828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 67765) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 271247) |
207RN0300X Internal Medicine, Nephrology (Licence: NC RTL20-0013) | |
Enumeration Date | 2017-07-20 |
Last Update Date | 2025-03-06 |