| NPI | 1952930455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: DC MD600004069) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 79324) |
| 207RN0300X Internal Medicine, Nephrology (Licence: MD D0103759) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: VA 0101286594) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2025-10-10 |