| NPI | 1912336199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CT 60348) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME122471) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN17497) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2018-05-02 |