| NPI | 1407209554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 313720) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10057159) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2024-04-10 |