| NPI | 1437845575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP100848837) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10084837) |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-12 |