| NPI | 1851904601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME163750) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME163750) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: GA 90235) | |
| Enumeration Date | 2020-08-30 |
| Last Update Date | 2026-05-13 |