| NPI | 1396468344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 26773) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10080712) |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2025-07-21 |