| NPI | 1538735329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX V6733) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V6733) |
| 207R00000X Internal Medicine (Licence: IA R-12103) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA MD-51114) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IA V6733) | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2026-04-15 |