| NPI | 1598726390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101246427) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2002002640) |
| 207R00000X Internal Medicine (Licence: TX k2567) | |
| 208000000X Pediatrics (Licence: TX K2567) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2023-02-24 |