| NPI | 1013273259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 26251) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q4458) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2024-10-29 |