| NPI | 1740977008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MT227708) |
| 207RN0300X Internal Medicine, Nephrology (Licence: PA MT227708) | |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2026-07-01 |