| NPI | 1427439074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 7993) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R6289) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2026-06-15 |