| NPI | 1174627442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U0203) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301066837) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2025-09-10 |