| NPI | 1962765024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX R7840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 48247) |
| 208M00000X Hospitalist (Licence: KY 48247) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2020-01-28 |