| NPI | 1639150717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 330014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L8967) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2024-09-04 |