| NPI | 1699968560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX N2126) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX N2126) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP30027810) | |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2020-03-06 |