| NPI | 1033640784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U2896) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 43092) |
| 207R00000X Internal Medicine (Licence: NM MD2019-1066) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-09-23 |