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Riviera is of Latin descent (in the European Spanish dub he's given an Argentinian accent) and has a medical degree from Hollywood Upstairs Medical College (there he apparently spent much of his time using his ability to acquire prescription drugs to impress a succession of attractive women back in the 1970s), and a great deal of luck; thus far, none of the patients he has swindled, maimed, or given useless or dangerous medical advice seems to have sued him (although a few have come after him in person, for example in "Homer's Triple Bypass" a large angry man grabs him, and Nick says "Well if it isn't my old friend Mr. McGregg - with a leg for an arm and an arm for a leg"; the man literally has an arm where a leg should be and a leg where an arm should be). Dr. Nick is a stereotype of shady, immoral doctors who perform medical procedures for money with little or no regard for medical ethics, or their patients' well-being. In the episode "Much Apu About Nothing", he is seen taking a citizenship test, implying he is not a citizen of the United States. Some of his exclamations hint that he may be Argentinian, though the show offered no direct evidence of this.