| NPI | 1982287967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2024-0587) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: TX BP20090429) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2024-10-08 |