| NPI | 1154950186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX W5947) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-06-03 |