| NPI | 1417164831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.29682) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T7180) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2025-09-09 |