| NPI | 1134388218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A11272) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2018-02634) |
| 207R00000X Internal Medicine (Licence: WA OP60859085) | |
| 207R00000X Internal Medicine (Licence: GA 081063) | |
| 207R00000X Internal Medicine (Licence: TX R9224) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2021-08-16 |