| NPI | 1972866291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: FL ME148282) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: NV 17181) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-07-08 |