| NPI | 1598915019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 003415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P1949) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2026-03-23 |