| NPI | 1881116291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD487175) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 305436) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT231549) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: PA MT231549) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2024-10-28 |