| NPI | 1447368576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C182225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 44296) |
| 207R00000X Internal Medicine (Licence: TX L1068) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2023-05-09 |