| NPI | 1265095160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 35091) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101284157) |
| 207R00000X Internal Medicine (Licence: TX BP10067181) | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2025-06-09 |