| NPI | 1750020558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA HS000110L) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP05590) |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2025-06-28 |