| NPI | 1497247332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V5233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A174865) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2025-02-24 |