| NPI | 1770593063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: WV 1996) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 1996) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 34.008972) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2021-04-07 |