| NPI | 1780047233 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: VA 0101271364)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 64119)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-01 | 
| Last Update Date | 2022-08-03 |