| NPI | 1811284078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX R1843) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME122111) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX R8173) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN# 15763) | |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2023-03-28 |