| NPI | 1073527339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX u2001) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 21646) |
| 207R00000X Internal Medicine (Licence: NC 2010-01883) | |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2023-12-18 |