| NPI | 1427511849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA OP61387015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T6534) |
| 207R00000X Internal Medicine (Licence: MA 292537) | |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2023-07-27 |