| NPI | 1760117519 |
|---|---|
| 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: TX BP10080268) |
| Enumeration Date | 2022-07-17 |
| Last Update Date | 2024-07-17 |