| NPI | 1588682983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 273031) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M7826) |
| 207R00000X Internal Medicine (Licence: TN 2093) | |
| 207R00000X Internal Medicine (Licence: RI DO01379) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2026-06-01 |