| NPI | 1841863115 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX BP10089934) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX BP10089934) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-07-23 | 
| Last Update Date | 2024-06-21 |