| NPI | 1316529225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 43359) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A184013) |
| 207R00000X Internal Medicine (Licence: MO 2024032187) | |
| 207R00000X Internal Medicine (Licence: TX V1494) | |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2024-08-22 |