| NPI | 1922539857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME152163) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: FL ME152163) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: FL ME152163) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2025-09-18 |