| NPI | 1437726841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO223602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 726594) |
| Enumeration Date | 2021-06-06 |
| Last Update Date | 2025-09-21 |