| NPI | 1205326832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V1143) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 37887) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2026-03-26 |