| NPI | 1770077125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD484019) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301115169) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2024-09-23 |