| NPI | 1043659345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX R3337) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103175) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2025-07-16 |