| NPI | 1407318470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX V2028) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 332570) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-07-08 |