| NPI | 1396305439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 326666) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U9467) |
| 207RN0300X Internal Medicine, Nephrology (Licence: NY 326666) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2024-08-18 |