| NPI | 1063707073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.136013) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C188638) |
| 207R00000X Internal Medicine (Licence: TX U6897) | |
| 207R00000X Internal Medicine (Licence: NY 318467) | |
| 207R00000X Internal Medicine (Licence: MD D98635) | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2024-11-18 |