| NPI | 1902349822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 313610) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NY 313610) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-11-25 |
| Last Update Date | 2023-03-19 |