| NPI | 1982164141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 25327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 151744) |
| 207R00000X Internal Medicine (Licence: TX 5904) | |
| 207R00000X Internal Medicine (Licence: VA 0101275304) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2024-07-05 |