| NPI | 1275808529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U6010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA Md.207391) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2026-01-07 |