NPI | 1790924777 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 268726) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 241808) |
363A00000X Physician Assistant (Licence: NY 268726) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-02-13 |
Last Update Date | 2023-07-07 |