| NPI | 1437545043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T5083) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 1556) |
| 208D00000X General Practice (Licence: NE 1556) | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2023-12-22 |