| NPI | 1568565661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.025716) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 068410) |
| 207R00000X Internal Medicine (Licence: TX L7725) | |
| 207R00000X Internal Medicine (Licence: OK 26654) | |
| 207R00000X Internal Medicine (Licence: FL ME107747) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2023-05-02 |