| NPI | 1912387713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A155033) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 264157) |
| 207R00000X Internal Medicine (Licence: CA A155033) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2022-04-19 |