| NPI | 1730318817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME123975) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: PA md447055) | |
| 207R00000X Internal Medicine (Licence: NY 268406) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2017-04-25 |