| NPI | 1437500550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2019-0197) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 32285) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2023-05-01 |