| NPI | 1366604423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0008X Internal Medicine, Hepatology (Licence: UT 8720193-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N7961) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10032406) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2021-11-11 |