| NPI | 1639599632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX R1917) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R1917) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2022-11-11 |