| NPI | 1245682020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U5931) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS16150) |
| 207R00000X Internal Medicine (Licence: CO TL.0005950) | |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2023-08-25 |