| NPI | 1457609638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX P9364) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P9364) |
| 208000000X Pediatrics (Licence: TX P9364) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2019-10-10 |