NPI | 1881011260 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME139931) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 19455) |
Enumeration Date | 2014-03-24 |
Last Update Date | 2023-09-14 |