| NPI | 1871989731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX U5213) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 80370) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 80370) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-08-29 |