| NPI | 1356409437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-12394) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL SP-158) |
| 207R00000X Internal Medicine (Licence: KY 36303) | |
| 207R00000X Internal Medicine (Licence: WI 43784020) | |
| 207R00000X Internal Medicine (Licence: TX N3412) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-05-15 |