| NPI | 1982966834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 056567) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CT 056567) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2017-07-28 |