| NPI | 1538396858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P8942) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP1-0035519) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2025-09-02 |