| NPI | 1437103520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS17989) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L0688) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2025-06-12 |