| NPI | 1669903886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX T0751) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL DO.1921) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-01-11 |