| NPI | 1609379411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX S4316) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX S4316) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX S4316) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2023-09-15 |