| NPI | 1710516612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: TX V7290) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2025-05-21 |