| NPI | 1821448341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PR 21404) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 21404) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 21404) | |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2021-07-20 |