| 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 |