| NPI | 1790129831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: UT 9158339-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 9158339-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2021-10-28 |