NPI | 1780062257 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA MD470880) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-05-15 |
Last Update Date | 2021-05-27 |