| NPI | 1518457837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T1100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10063876) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2026-03-17 |