| NPI | 1437652237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2021-01514) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10063645) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2021-05-18 |