| NPI | 1376757609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q4840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036125007) |
| 207R00000X Internal Medicine (Licence: OH 35.89272) | |
| 207R00000X Internal Medicine (Licence: PA MD432937) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-08-23 |