| NPI | 1073535266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD150952) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M2333) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2026-02-04 |