| NPI | 1194144535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX S6161) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA 307570) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2021-09-26 |