| NPI | 1265066419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T2788) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10070778) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2023-06-13 |