| NPI | 1336609510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U6332) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: HI MD-25537) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-08-05 |