NPI | 1295231934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V3581) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101268587) |
208D00000X General Practice (Licence: VA 0101268587) | |
Enumeration Date | 2018-04-02 |
Last Update Date | 2025-08-06 |