| NPI | 1073923546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX R3875) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: TX R3875) | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2021-11-02 |