| NPI | 1922447069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: WA MD60890396) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 60296) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0004905) | |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2019-07-02 |