| NPI | 1750735700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: WA 61181685) |
| 207RN0300X Internal Medicine Nephrology (Licence: OR 204924) | |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2022-10-27 |