| NPI | 1942794573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PR 23698) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 34392) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2024-04-23 |